Cyanoacrylate embolization of nearly all types of refractory gastrointestinal fistulae is a feasible and harmless technique. Prospective controlled studies are required to support the available evidence.
Antibiotic agents are not necessary for uncomplicated subcutaneous abscesses after I&D. These cases can be managed safely on an outpatient basis without any increase in morbidity.
Introduction:The third trimester of pregnancy has long been considered a suboptimal time frame for undergoing biliary laparoscopic procedures, primarily because of maternal-fetal risks and technical issues. We present the case of a 34-year-old woman at 32 weeks' gestation who underwent laparoscopic common bile duct (CBD) exploration and cholecystectomy to treat symptomatic cholelithiasis and giant choledocholithiasis.
Case Description:The patient was complaining of right upper quadrant pain, nausea, and vomiting. Physical examination revealed tenderness and Murphy's sign. Liver function test results showed a pattern of obstructive jaundice, and biliary ultrasonography confirmed dilation of the CBD. Endoscopic retrograde cholangiopancreatography with sphincterotomy was unsuccessful at clearing the CBD because of the size of the stones, thus a decision was made to perform a laparoscopic CBD exploration with cholecystectomy. The patient's postoperative course was uneventful, and she delivered a healthy girl at 37 weeks.
Conclusion:This report provides insight regarding the role that laparoscopy may play in the management of CBD stones in late pregnancy when other nonoperative alternatives have proven unsuccessful.
According to our results, LigaSure could be used to perform laparoscopic sleeve gastrectomy with reduction of staple-line bleeding and, when reinforced with a running suture, it achieves a strength that approaches that of staples plus oversewing.
We contend that the narrator in Edgar Allan Poe's “The Black Cat” is horrified not only by the way his reason degenerates over the course of the tale but also by the increasingly passive, feminized figure that he feels he has become. In short, we argue that his terror develops not only from a perceived loss of mind but also of manhood. An allusion in the tale to Henry Fuseli's The Nightmare, which Poe almost certainly knew about, is a cipher of sorts, an important clue to help readers understand the terror the narrator experiences in “The Black Cat.” Fuseli's painting depicts an incubus sitting on the chest of a sleeping woman, filling the spectator with a sense of terror. A similar reaction occurs when reading “The Black Cat.” Like the narrator, who believes an innocent cat is actually a demon sent to torture him, readers are horrified by the gender reversal which Poe portrays. Poe exploits masculine gender constructs which claim that the distinguishing characteristic of men is their heightened ability to reason by showing a man completely at the mercy of his passions and instincts, just as the sleeping woman in Fuseli's painting is held captive by the perverse imp. If the reader is unaware of Fuseli's painting, or does not grasp Poe's clever reversal of gender roles in the story, then this horror remains shrouded in mystery.
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